OSCE Toolbox | Oral Symptoms 2 - Scenario

Report a problem

Scenarios

By Femi Lana • September 24, 2025 • Last reviewed: 24/09/25 •

Ready to dive into this scenario?

Log in or sign up to add it to your favourites and show your support

Add to Favourites

Summary Beginner

In this scenario, the student pharmacist is tasked with counselling a patient who has been experiencing dry mouth and bad breath. The student must provide appropriate advice and answer any questions they have.

Please ensure that this scenario and mark scheme align with the most up-to-date guidelines from the UK NICE and the BNF when using it for your OSCE assessment.

You will need a student pharmacist and an actor for this OSCE station.

Revision Topics

Be aware, this may reveal any answers!

Student Instructions

Actor Instructions

This may reveal scenario objectives!

You are Alexei Petrov (ah-LEK-say PYEH-trof)

Opening Statement: “My mouth has been getting a bit dry and I think it's starting to affect my breath.”

Patient Information

Name: Alexei Petrov

Age: 18

Symptoms:

“For the last 6 or 7 months I’ve been noticing my mouth is a bit dry. It didn’t bother me at first but now I’m always conscious that my breath smells.”
If asked: “I have had a bit of an ongoing cough.” If asked what comes up, “Nothing comes up - it's a dry cough and happens a few times throughout the day.”
If asked: “I’ve been drinking more water but the dryness is still there.”
If asked, “I’ve not really had this before, no.”

Important negatives:

“I’ve not had any pain in my mouth or teeth - it's more just the discomfort.”
“I’ve not noticed any redness or swelling in my mouth.”
“I've not had any issues with my appetite or taste.”
“I haven’t noticed any weight loss.”
“I’ve not had any joint pain or aches.”
“I’ve not been having to urinate more often.”
No other symptoms.

Past medical history:

“I’ve got a bit of eczema.”

Medication history:

“I only use creams like E45. If my eczema plays up some 1% hydrocortisone cream always settles it for me.”

Allergies:

“I think I have a penicillin allergy - my mum told me I got a rash when I was younger.”

Lifestyle factors:

“I eat whatever really - takeouts or ready meals. Whatever I have time for.”
“I have a couple of beers every other weekend.”
“I don’t smoke but I started vaping - it's been around 8 months.” Only if asked, “ I get through 1 vape a week. I buy the 4,000 puff ones. My friends think it’s quite a lot, but I really enjoy it and it’s just become a habit.”

If advised to stop vaping, you are quite defensive and adamant that you do not wish to.
Become angry if the student persists after you have made it clear that it is not something you want to discuss right now, but allow them to offer to see you in the future about it.

“My job is quite physical and I don’t have time for exercise.”
“I’m a construction worker so I can get quite warm while working which makes my mouth feel worse.”

Questions to ask (use to prompt the student if they miss these areas):

What do you think is causing my symptoms? (Prompt them to give their thoughts as this is important to say the marks)
Is there anything I can do to improve my symptoms?

Mark Scheme

Introduction

0 / 2

Introduce yourself as the pharmacist with an appropriate greeting

+1

Confirms patient details: Name and age

+1

Answer Q1: What do you think is causing my symptoms?

0 / 2

Student uses symptoms to come to an appropriate diagnosis:

Explain that dry mouth is a possible side-effect of vaping and given that their symptoms started around the same time that they started vaping, it's quite likely the cause.

+1

Explain that saliva has antibacterial properties and helps to prevent plaque-build up, which is why a dry mouth can lead to bad breath.

+1

Answer Q2: Are there more side-effects of vaping?

0 / 1

Explain that other side-effects of vaping include: (Maximum of 2 marks awarded) :

Mouth and throat irritation

Shortness of breath

Headaches

Advise the patient to see their GP if they experience any side-effects of vaping after trying self-help.

+1

TePe’s Hydrating Mouth Gel provides immediate dry mouth relief and can be used on the go, and can be used as often as needed.

Answer Q3: Is there anything I can do to improve my symptoms?

0 / 5

Offers appropriate and relevant advice on managing patient symptoms:

Dry mouth:

Advise the patient to drink plenty of cold water as dehydration is the most common cause of dry mouth. They can also suck on sugar free lozenges or sugar free hard boiled sweets and drink small sips of water often

+1

Advise maintaining good oral hygiene when brushing such as by brushing twice a day using a fluoride toothpaste and informing the patient to spit rather than rinse.

+1

Advise the patient to clean in between their teeth daily.

+1

Recommend hydrating mouthwashes, sprays and gels to soothe dryness and help with mouth odour.

+1

TePe’s Hydrating Mouthwash both soothes and eases dry mouth, and contains 0.2% fluoride which helps to prevent cavities.

Advise the patient that the best solution is to try and reduce the amount they vape or quit entirely, but that they should speak to a stop smoking specialist for advice when they feel ready to think about quitting.

+1

Management

0 / 2

Makes appropriate health referrals:

Refers patient to a stop-smoking specialist/local services to discuss their symptoms and side-effects.

+1

Advises the patient to return to the pharmacy or speak to their GP if symptoms do not improve within a few weeks.

+1

Communication

0 / 5

Use appropriate language for the person and situation.

+1

Ensures the patient understands what has been discussed and understands what to do if they experience any concerning symptoms.

+1

Signposts and refers patients to relevant resources e.g. NHS website

+1

Conclude the conversation professionally, reassuring the patient and offering to assist with any further questions or concerns.

+1

The student did not say anything that could harm the patient

+1

This includes but is not limited to, providing incorrect information or medication, misdiagnosing conditions, neglecting to inquire about allergies, making incorrect referrals, or failing to act on red-flag symptoms.